Equality in maternal and newborn health: Modelling geographic disparities in utilisation of care in five East African countries
Background: Geographic accessibility to health facilities represents a fundamental barrier to utilisation of maternal and newborn health (MNH) services, driving historically hidden spatial pockets of localized inequalities. Here, we examine utilisation of MNH care as an emergent property of accessibility, highlighting high-resolution spatial heterogeneity and sub-national inequalities in receiving care before, during, and after delivery […]
Coverage and determinants of modern contraceptive use in sub-Saharan Africa: further analysis of demographic and health surveys
Background: The use of modern contraceptives (MC) in most African countries has been low despite the high fertility rate and unmet need for family planning. This study sought to determine the coverage and determinants of modern contraceptive use among women of reproductive age (15-49 years) in sub-Saharan Africa (SSA). Methods: Data for the study were obtained […]
Equity of inpatient health care in rural Tanzania: A population- and facility-based survey
Objective. To explore the equity of utilization of inpatient health care at rural Tanzanian health centers through the use of a short wealth questionnaire. Methods. Patients admitted to four rural health centers in the Kigoma Region of Tanzania from May 2008 to May 2009 were surveyed about their illness, asset ownership and demographics. Principal component […]
The effect of ethiopia’s community-based health insurance scheme on revenues and quality of care
Ethiopia’s Community-Based Health Insurance (CBHI) scheme was established with the objectives of enhancing access to health care, reducing out-of-pocket expenditure (OOP), mobilizing financial resources and enhancing the quality of health care. Previous analyses have shown that the scheme has enhanced health care access and led to reductions in OOP. This paper examines the impact of […]
Cluster-randomized study of intermittent preventive treatment for malaria in infants (IPTi) in southern Tanzania: Evaluation of impact on survival
Background: Intermittent Preventive Treatment for malaria control in infants (IPTi) consists of the administration of a treatment dose of an anti-malarial drug, usually sulphadoxine-pyrimethamine, at scheduled intervals, regardless of the presence of Plasmodium falciparum infection. A pooled analysis of individually randomized trials reported that IPTi reduced clinical episodes by 30%. This study evaluated the effect […]
Pooled prevalence and associated factors of diarrhea among under-five years children in East Africa: A multilevel logistic regression analysis
Background Worldwide, diarrhea is the second most common cause of death and morbidity among under-five years’ children. In sub-saran Africa, access to water, sanitation, and hygiene are very scanty and the burden of diarrhea diseases is countless relative to the rest of the world. Prior studies conducted in East Africa vary in design, sample size, […]
Moving toward patient-centered care in Africa: A discrete choice experiment of preferences for delivery care among 3,003 Tanzanian women
Objective: In order to develop patient-centered care we need to know what patients want and how changing socio-demographic factors shape their preferences. Methods: We fielded a structured questionnaire that included a discrete choice experiment to investigate women’s preferences for place of delivery care in four rural districts of Pwani Region, Tanzania. The discrete choice experiment […]
Malaria and Fetal Growth Alterations in the 3rd Trimester of Pregnancy: A Longitudinal Ultrasound Study
Background: Pregnancy associated malaria is associated with decreased birth weight, but in-utero evaluation of fetal growth alterations is rarely performed. The objective of this study was to investigate malaria induced changes in fetal growth during the 3rd trimester using trans-abdominal ultrasound. Methods: An observational study of 876 pregnant women (398 primi- and secundigravidae and 478 […]
Determinants of diarrhoeal diseases and height-for-age Z-scores in children under five years of age in rural central Tanzania
Introduction. Childhood diarrhoeal diseases and stunting are major health problems in low- and middle-income countries (LMICs). Poor water supply, sanitation services and hygiene, frequently encountered in resource-poor settings, contribute to childhood diarrhoea and stunting. Methods. Data on demographic characteristics, hygiene practices, sanitation and human-animal interactions (predictors) and child height-for-age z-scores (HAZ) (outcome) were collected once, […]
Determinants of postnatal care use at health facilities in rural Tanzania: Multilevel analysis of a household survey
Background: Postnatal care (PNC) for the mother and infant is a neglected area, even for women who give birth in a health facility. Currently, there is very little evidence on the determinants of use of postnatal care from health facilities in Tanzania. Methods: This study examined the role of individual and community-level variables on the […]